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Eisai Assistance Program (Akynzeo)
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2730 S. Edmonds Lane
Suite 300
Lewisville, TX 75067
Phone
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(855)347-2448
Fax:
(844)494-8063
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Eligibility
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Insurance requirements are determined case by case, this includes Medicare part D Patients. Income requirements for this program have not been disclosed. Patient must be a US citizen or legal resident. |
| Who Can Apply
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Call for application to be faxed or download from website. Application is to be faxed back to company. Patient and Doctor will be notified of decision. |
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Required
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Must have medically appropriate condition/diagnosis. Doctor must complete application, sign and attach brand name prescription. Patient must complete application, sign and attach proof of income. |
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Supply
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Amount as prescribed by Doctor. Contact company for refills, which are determined case by case. Refill limit & re-application process not specified. |
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Ship To
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Medication is sent to Doctor's office or specific site in 1-3 business days. |
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Note
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Includes Support for This Drug
NOTE: Linked drugs are available for Prescribers to Apply Online now.
Click drug logo or drug name to start online application.
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| Akynzeo capsule |
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